Journal of Community Health

, Volume 35, Issue 1, pp 53–59 | Cite as

Minding the Immunization Gap: Family Characteristics Associated with Completion Rates in Rural Ethiopia

  • Mary-Christine Sullivan
  • Ayalew Tegegn
  • Fasil Tessema
  • Sandro Galea
  • Craig Hadley
Original Paper


To examine risk factors for lack of immunization, we tested the impact of maternal, paternal, and household variables on child immunization status in children ≥1 year in a rural area of Ethiopia. Data collected by face-to-face interview on maternal, paternal, household and child variables from cross-sectional random sample community-based study on health and well-being in rural Ethiopia was used to test hypotheses on immunization status of children (n = 924). Bivariate and multivariate logistic regression models were used for two immunization outcomes: record of at least one vaccination, and record of DPT3, indicating completion of the DPT series. Complete data were available for 924 children ≥1 year of which 79% had at least one vaccination. Of those, 64% had DPT3/Polio3; below recommended coverage level. Children were more likely to be vaccinated if the mother reported antenatal care (ANC), and less likely to be vaccinated if the mother had a history of stillbirth, and no opinion of health center. Children were more likely to have DPT3 if: mother had ≥1 year of education, mother reported ANC, or older paternal age. Children were less likely to have DPT3 in households with food insecurity and no maternal opinion of health center. The study had three findings with implications for immunization programming: (1) Mothers completing the recommended ANC visits is strongly associated with receiving at least one vaccination and with completing a vaccination series; (2) Maternal education is associated with a completed vaccination series; (3) Paternal characteristics may affect vaccination series completion.


ANC DPT3 Immunization 



The authors are grateful to the local staff of GGGDS and colleagues at Jimma University for their support and work during data collection and manuscript preparation, and to the community of Gilgel Gibe for their on-going support and participation in this study. Funding for the Gilgel Gibe Growth and Development Study (GGGDS) study is provided by the Michigan Interdisciplinary Center on Social Inequality, Mind and Body (R24 HD047861) and start up funds. Conflict of Interest: None declared.


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Mary-Christine Sullivan
    • 1
    • 2
  • Ayalew Tegegn
    • 3
  • Fasil Tessema
    • 3
  • Sandro Galea
    • 4
  • Craig Hadley
    • 5
  1. 1.Hubert Department of Global Health, Rollins School of Public HealthEmory UniversityAtlantaUSA
  2. 2.Yale School of NursingNew HavenUSA
  3. 3.Department of Biostatistics and EpidemiologyJimma UniversityJimmaEthiopia
  4. 4.University of Michigan School of Public HealthAnn ArborUSA
  5. 5.Department of AnthropologyEmory UniversityAtlantaUSA

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